Reverse shoulder arthroplasty for deltoid-deficient shoulder following latissimus dorsi flap transfer. Case report
| Autor: | Mohamed Al Ateeq Al Dosari, Shamsi Hameed, Khalid Mukhtar, Aissam Elmhiregh |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Shoulders medicine.medical_treatment Deltoid curve Gun shot Article 03 medical and health sciences 0302 clinical medicine Deltoid muscle Case report medicine Rotator cuff Lattisimus dorsi 030222 orthopedics Deltoid business.industry 030229 sport sciences musculoskeletal system Arthroplasty Surgery body regions Reverse shoulder arthroplasty medicine.anatomical_structure Upper limb Presentation (obstetrics) business Range of motion human activities |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2017.08.042 |
| Popis: | Highlights • Traumatic shoulder injury resulting in arthritis with loss of the rotator cuff and deltoid muscles. • Shoulder muscles reconstruction using a Lattisimus dorsi flap. • Preoperative (Arthroplasty) assessment and examination. • Preoperative planning prior to shoulder joint reconstruction. • Post-operative physiotherapy and follow up. Introduction The usual indication for reverse shoulder arthroplasty is glenohumeral arthritis with inadequate rotator cuff and intact deltoid muscle. We report here a case of reverse shoulder arthroplasty using a lattisimus dorsi flap in a patient with deltoid-deficient shoulder following a gunshot injury. Presentation of the case The patient was an otherwise healthy 51-year-old male with a history of gunshot injury of the left shoulder 2006. Upon presentation in 2011, the patient had a loss of most of his shoulder bony and muscular structures. Due to deltoid muscle deficiency, the patient underwent Lattisimus Dorsi muscle flap followed by reverse shoulder arthroplasty in order to establish an upper limb function. Upon discharge, 11 days after the surgery, the patient was able to achieve 150° flexion and 90° abduction while in the supine position and 45° in each direction, while sitting. He was able to perform internal rotation (behind back) up to the level of the L1 vertebra, assisted active abduction of 90°, and external rotation of 20°. Power tests showed power of grade 4/5 for both shoulder flexion and extension and grade 2+/5 for both abduction and adduction. At the last follow up one year after the operation, The patient still had passive pain-free full range of motion, but no progress in active range of motion beyond that upon discharge. Conclusion Reverse shoulder arthroplasty after Latissmus dori flap in patient with deltoid deficient shoulders can be a successful and reproducible approach to treat such conditions. |
| Databáze: | OpenAIRE |
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